Many women still confused about perimenopause, research finds

One in three US women older than 35 are no sure whether they are in perimenopause, new research has revealed.

The findings suggest uncertainty remains common, largely because of knowledge gaps, symptom confusion and difficulty getting confirmation or care.

Perimenopause is the transitional stage before a woman’s final period, when hormone levels fluctuate and symptoms can change over time.

It usually begins in the mid-40s, although timing varies widely, and can last for around four to eight years.

Symptoms can include hot flushes, psychological symptoms and urogenital symptoms, which affect the urinary and genital areas.

Dr Stephanie Faubion, medical director for The Menopause Society and one of the study authors, said: “This large study showed that one in three US women aged older than 35 years are not sure whether they are in perimenopause.

“Further, the study highlights that symptom confusion, misconceptions, and barriers to care are leaving many women without the clarity and support they need during the menopause transition.

“Recognising perimenopause uncertainty as a common experience can help shift the conversation from searching for a diagnosis to providing women with the information, validation, and support they need to navigate this natural life transition with confidence.”

More than 7,600 US women aged 35 and older took part in the study, which looked at how common uncertainty around perimenopause is and what may be driving it.

Overall, 34 per cent of participants said they were unsure of their reproductive stage.

Uncertainty varied by age and symptom burden, reaching 42 per cent among women aged 40 to 44 and 37 per cent among those with severe symptoms.

Symptom confusion was the most common factor, cited in 56 per cent of responses.

This included difficulty making sense of bodily changes and telling perimenopause apart from other possible causes, such as premenstrual syndrome, thyroid disease or mental health conditions.

Knowledge gaps and information-seeking made up 28 per cent of responses, reflecting limited awareness, age-based assumptions and attempts to find reliable information.

Barriers to confirmation and care made up 16 per cent, including dismissive healthcare encounters and reluctance to acknowledge perimenopause.

Younger women aged 35 to 39 were more likely to cite knowledge gaps, while healthcare barriers were most common among women aged 40 to 44.

The researchers said clinicians should take a more flexible approach to recognising the emotional, cognitive and physical symptoms that can occur during perimenopause.

They said healthcare professionals should not rely too heavily on irregular periods as the main sign, because some women have symptoms before major cycle changes.